California Medi-Cal eligibility comes down to three things: your income, your household category, and your California residency. Most single adults under 65 qualify with annual income at or below roughly $22,025 in 2026, which is 138% of the Federal Poverty Level.1California Department of Health Care Services. 2026 Federal Poverty Levels Children, pregnant individuals, seniors, and people with disabilities each have their own thresholds, and immigration status is no longer a barrier to full-scope coverage for anyone who meets the financial rules.
Income Limits for 2026
Medi-Cal measures income against the Federal Poverty Level, which for 2026 is $15,960 a year for one person and $33,000 for a family of four.2ASPE. 2026 Poverty Guidelines Most adults qualify at 138% of that figure: about $22,025 for a single person, $45,540 for a family of four.1California Department of Health Care Services. 2026 Federal Poverty Levels
Higher limits apply to some groups. Pregnant individuals can earn up to 213% of the poverty level and still get full-scope coverage. Children and teens may qualify at household incomes as high as 266% of poverty, depending on their age and the specific program.3California Department of Health Care Services. 2025 Federal Poverty Levels – Section: Enclosure 3
What counts as income is your gross earnings before most deductions: wages, Social Security, unemployment, and similar sources. Self-employment income gets reduced by legitimate business expenses. For most applicants, Medi-Cal uses Modified Adjusted Gross Income — the same framework as your federal taxes — which looks at what you earn now rather than past accumulations. If your income varies, report what you currently earn rather than averaging prior months.
Which Category You Fit Into
Qualifying for Medi-Cal means fitting into one of several groups. In practice, these cover most low-income Californians.4Department of Health Care Services. Medi-Cal Overview
- Adults ages 19 through 64 whose income is at or below 138% of the Federal Poverty Level qualify through the Affordable Care Act expansion group.
- Children and teens qualify at higher thresholds, up to 266% of poverty depending on age and program.
- Pregnant individuals qualify up to 213% of poverty, with full-scope coverage continuing through the end of the month 12 months after delivery.
- Seniors age 65 and older qualify through the Aged, Blind, and Disabled Federal Poverty Level program, with asset limits applying.
- People with disabilities qualify through the same Aged, Blind, and Disabled pathway after a medical determination.
- Former foster youth are covered up to age 26 regardless of income, if they were in foster care and enrolled in Medicaid at age 18 or older.
These categories fall into two administrative tracks. The MAGI track covers adults under 65, children, and pregnant individuals: no asset test, straightforward tax-based income counting. The non-MAGI track covers seniors and people with disabilities, with asset limits and sometimes different income rules.5Department of Health Care Services. Medi-Cal Help Center
Assets: When They Matter and When They Don’t
For most adults under 65, children, and pregnant individuals, assets are not counted. Only income matters. This is a federal rule.
Assets do count for the non-MAGI groups: people 65 and older, those with disabilities, nursing home residents, and families whose income exceeds MAGI thresholds. The California limit is $130,000 for one person, plus $65,000 for each additional household member up to ten people.6Department of Health Care Services. Asset Limit Frequently Asked Questions That ceiling is far higher than the old $2,000 cap, so many seniors and people with disabilities who were previously turned away now qualify.
Your primary home and one vehicle are excluded. Countable assets include bank accounts, cash, stocks, bonds, and additional real estate. If you’re over the limit, spending down on medical bills, household necessities, rent, or mortgage payments can bring you under.6Department of Health Care Services. Asset Limit Frequently Asked Questions
Residency and Immigration Status
You must live in California and intend to stay. There’s no minimum time requirement. A lease, utility bill, or similar document showing a California address verifies residency.
California has removed immigration status as a barrier to full-scope Medi-Cal. Coverage expanded in phases: children first, then young adults 19 to 25, then adults 50 and older, and finally adults 26 to 49 beginning January 1, 2024.7Medi-Cal. Ages 26 Through 49 Adult Full Scope Medi-Cal Expansion Any low-income California resident can now receive full benefits regardless of immigration status if they meet the financial and category rules.
Applicants who have a Social Security Number should provide it. Those who don’t — and aren’t eligible for one — can supply an Individual Taxpayer Identification Number or sign a statement that they have no Social Security Number. The absence of one won’t block enrollment.
What If Your Income Is Slightly Too High
If you earn too much for free Medi-Cal but face significant medical expenses, the Medically Needy pathway may still cover you. You pay a monthly “share of cost,” which is the gap between your income and the state’s maintenance need level, and Medi-Cal covers the rest once you reach it.
It works like a monthly deductible. If your income exceeds the standard by $400, you are responsible for the first $400 of medical costs that month. Once you hit that figure through doctor bills, prescriptions, hospital charges, or insurance premiums, Medi-Cal covers everything else for the remainder of the month. Even unpaid bills from providers can count toward your share. This pathway is most useful for seniors and people with disabilities whose income lands just above the regular threshold but who have ongoing medical costs. Your county office calculates the exact amount when you apply.
How to Apply
Before you start, gather proof of income (a recent pay stub or your most recent federal tax return), proof of your California address (a lease, utility bill, or piece of mail), and identification for each household member applying (driver’s license, birth certificate, or passport).8Department of Health Care Services. Medi-Cal Request for Information MC 355 Immigration documents can be included but aren’t required for eligibility. Report monthly gross income before taxes.
The fastest route is online through BenefitsCal, the state benefits portal, where you can complete the application and upload documents in one session.9BenefitsCal. BenefitsCal Covered California’s marketplace also accepts Medi-Cal applications and will redirect you to subsidized private plans if your income is too high.10Department of Health Care Services. Apply for Medi-Cal You can also mail or drop off a paper application at your county social services office.
The state must process standard applications within 45 days. Disability-related applications get up to 90 days because of the medical determination involved.11California Department of Health Care Services. Medi-Cal Eligibility Division Information Letter No. I 23-55 You’ll receive a Notice of Action with the decision. Keep copies of everything you submit.
Coverage for Bills You Already Have
Medi-Cal can cover medical expenses you incurred up to three months before you applied, provided you would have qualified during those months. If an emergency room visit or other medical cost came before your application, the state can reimburse you or pay the provider directly once you’re approved.12Department of Health Care Services. Medi-Cal Reimbursement for Medical Expenses
The services must have been medically necessary and the type of care Medi-Cal covers. If you paid out of pocket, request reimbursement through your county office. This three-month lookback is one of the most underused features of the program, so don’t assume earlier bills are only your problem.
Keeping Your Coverage
Eligibility is reviewed every 12 months. Before your renewal date, the county first tries to confirm eligibility automatically using wage records, tax filings, and other electronic sources — an ex parte renewal. If the county can verify you still qualify without contacting you, coverage continues and you receive a notice.13Medicaid.gov. Basic Requirements for Conducting Ex Parte Renewals of Medicaid and CHIP Eligibility
If the automatic check fails, a renewal form arrives in the mail and you have at least 30 days to return it. Not responding is the single most common reason people lose Medi-Cal, even when they still qualify. If you move, update your address with your county office so renewal notices reach you.
Starting January 1, 2027, adults enrolled through the Medicaid expansion group (ages 19 to 64 at 138% of the Federal Poverty Level) will need to renew every six months instead of every 12. The new federal requirement does not apply to children, pregnant individuals, seniors, or people with disabilities, who remain on the annual cycle.14Medicaid.gov. Implementation of Eligibility Redeterminations, Section 71107 of the Working Families Tax Cut Legislation
If You’re Denied
If your application is denied, or if existing benefits are reduced or terminated, the Notice of Action will state the reason and your right to appeal. You can request a State Fair Hearing within 90 days.15eCFR. 42 CFR Part 431 Subpart E – Fair Hearings for Applicants and Beneficiaries
If you already receive Medi-Cal and request the hearing within 10 days of a termination or reduction notice, your benefits continue at the same level until the hearing is resolved. This is called aid paid pending. Miss the 10-day window and coverage can stop while you wait. You can request a hearing by phone, by mail, or online through BenefitsCal.